Clinical characteristics of novel coronavirus pneumonia with diarrhea

ABSTRACT

Introduction: This study aimed to understand the clinical characteristics of patients with novel coronavirus pneumonia (2019-nCoV) combined with diarrhea and to explore its pathogenic mechanism. Materials and methods: The clinical data of 108 2019-nCoV patients (16 with diarrhea and 92 without diarrhea) were retrospectively analyzed. Results: Sixteen 2019-nCoV patients (14.8%) had diarrhea. This was watery stool, 2–5 times a day. The volume was about 150-200 mL/time, lasting 2-7 days, but the patients had no obvious abdominal pain, abdominal distension, digestive tract symptoms, or dehydration. Routine stool examination showed no obvious abnormal changes. The number of patients with or without diarrhea who had a history of contact with the epidemic area in Wuhan was seven (43.8%) and 48 (52.2%), respectively, P = 0.53. The average length of hospital stay for the group with diarrhea was 15.7 days, and 16.0 days for the group without diarrhea. The number of critically ill patients in the two groups was two (12.5%) and 12 (13%), respectively. Both groups of patients had symptoms such as fever, cough and sputum, chest tightness, and shortness of breath (P>0.1 for all). Both groups of patients had abnormal liver function, myocardial damage (increased LDH/HBDH, increased CK/CK-MB), increased CRP and interleukins, and the number of patients with decreased white blood cells, platelets, and lymphocytes in the two groups was similar (P>0.1). Conclusion: The mechanism of 2019-nCoV causing diarrhea may be that the virus enters the host cell by S1-protein binding to the human ACE2 receptor and infects the epithelial cells of the digestive tract to cause watery diarrhea, but the symptoms are mild, and the duration is short. The virus exists and replicates in the digestive tract;therefore, there is the possibility of a fecal-oral route of transmission. © 2021 A. CARBONE Editore. All rights reserved.